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Contractor's Application for Final Payment <br />Owner: City of Ramsey Owner's Project No.: 9002899 <br />Engineer: Bolton & Menk, Inc. Engineer's Project No.: 24X.135093 <br />Contractor: Kurilla Contracting Agency's Project No.: <br />Project: The Waterfront Trail Improvements <br />Contract: <br />Application No.: 4-FINAL Application Date: 11/24/2025 <br />Application Period: From 11/1/2024 to 11/21/2025 <br />1. Original Contract Price $ 191,415.00 <br />2. Net change by Change Orders $ 12,750.00 <br />3. Current Contract Price (Line 1 + Line 2) $ 204,165.00 <br />4. Total Work completed and materials stored to date <br />(Sum of Column G Lump Sum Total and Column J Unit Price Total) $ 182,795.40 <br />5. Retainage <br />a. X $ 182,795.40 Work Completed $ - <br />b. X $ - Stored Materials $ - <br />c. Total Retainage (Line 5.a + Line 5.b), $ - <br />6. Amount eligible to date (Line 4 - Line 5.c) $ 182,795.40 <br />7. Less previous payments $ 180,967.45 <br />8. Amount due this application $ 1,827.95 <br />9. Balance to finish, including retainage (Line 3 - Line 4) $ - <br />Contractor's Certification of Final Payment <br />The undersigned Contractor certifies, to the best of its knowledge, the following: <br />(1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on <br />account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for <br />Payment; <br />(2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for <br />Payment, will pass to Owner at time of payment free and clear of all liens, security interests, and encumbrances (except such as <br />are covered by a bond acceptable to Owner indemnifying Owner against any such liens, security interest, or encumbrances); <br />and <br />(3) All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective; and <br />(4) The provisions of M. S. 290.92 have been complied with and that all claims against me by reason of the Contract have been <br />paid or satisfactorily secured. <br />Contractor: Kurilla Contracting Co <br />Signature: o4ustivt �uri��a Date: 1/20/2026 <br />Name: Austin Kurilla Title: President <br />Recommended by Engineer Approved by Owner <br />By: ��a By: 1/Z ._:--- <br />Name: Zach Lingl Name: ti z0' l+�//- y v�i 2 /. GCj c <br />Title: Project Manager Title: fY 5 i T. <br />Date: 11/24/2025 Date: / .— : a - ,::), 6 <br />EJCDC C-620 Contractor's Application for Payment <br />(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved. <br />